GAO: Small Percentage Of Medicaid Enrollees Cost The Most

According to newly released findings from the Government Accountability Office (GAO), only 5% of Medicaid-only eligible enrollees accounted for nearly 50% of the billions of government dollars paid in Medicaid-only eligible claims between 2009 and 2011. Unlike the high-cost 5% group, the least expensive 50% of Medicaid-only enrollees accounted for less than 8% of the expenditures for those enrollees. For fiscal year 2013, Medicaid expenditures totaled about $460 billion, covering 72 million enrollees -some of whom were eligible for Medicare, too. The GAO suggests CMS improve efforts to manage expenditures and facilitate improvements to care by identifying additional information about Medicaid-only eligible enrollees responsible for a high proportion of expenditures.

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